The statistics from Allergy UK state that 45% of the population suffer from “food intolerance” symptoms such as gut problems, skin problems, headaches, migraines, joint pains, fatigue and low mood. However, when people talk about suffering from food reactions, whether allergy, intolerance or hyper-sensitivity, what do they mean? There is much confusion, particularly in the media, which makes the subject seem even more complicated that it already is! It is clear that food intolerance exists, over the years academics have debated the nomenclature behind food hypersensitivity to death, yet there are few resources available on the NHS that can help those with symptoms identify trigger foods and manage dietary changes. What is going on?

Let’s start by separating out “food allergy” from the mix; food allergy is an adverse immune reaction to a specific food. The body makes specific antibodies (IgE) to “fight off” the allergens found in these foods, when the food is next eaten, or sometimes is in contact with the skin, it triggers an immune system response which results in the release of histamine and other naturally occurring chemicals in the body. Symptoms caused by food allergy can range from rashes, swelling, diarrhoea and vomiting. In the most severe cases symptoms such as swelling of the lips, tongue or face, shortness of breath, breathing difficulties and loss of consciousness can occur; anaphylaxis which is potentially life threatening. Normally symptoms arise within a few minutes of eating or coming in to contact with the offending food, although they may be delayed by up to a couple of hours. Although true food allergy can be hugely significant for those who suffer it is actually quite rare with approximately 2.5% of the population diagnosed.

Leaving IgE antibody-mediated allergic reactions aside, what other types of reactions to foods are there? Food hypersensitivity can take on other forms such as (a) Coeliac disease; 1% of people in the UK have a specific immune reaction to gluten (found in wheat, barley and rye).This means that eating gluten damages the lining of the small intestine and affects other parts of the body as well. (b) The inability to break down milk sugar (lactose) which usually runs in families and can result in severe gut reactions, as can a deficiency in the enzyme needed to break down alcohol. (c) Chemical sensitivities such as reactions to food additives and other chemicals such as histamine, caffeine, sulphites and tyramine. These reactions usually occur quickly; think of the behaviour of a toddler being given brightly coloured sweets or fizzy drinks!

The majority of people, that have symptoms of food intolerance, do not come under any of the above categories. What about them? Some people will have just one symptom such as migraines others will have the misfortune to have several symptoms such as irritable bowel syndrome, migraine and a skin condition and or fatigue as well. Recognising that food is a trigger for a particular set of symptoms is not easy when, unlike food allergy and chemical sensitivity, where the symptoms are usually almost immediate, food intolerance symptoms appear hours, and often up to two or three days, later. For these sufferers there is often no clear diagnosis and it is usual that the symptoms get treated rather than the cause.

Where then do you start to look for food triggers? Currently the best accepted method for confirming food sensitivities is by elimination diet. This involves eating a restricted diet for several weeks. If there is no improvement during this time, it is assumed that the food type that has been restricted is not causing the symptoms, and the process is repeated with another food type. This method is time consuming, and it is very difficult to test all the different combinations of food types that may be causing the problems. For these people, one approach that has been used for many years is a strategy to “fast track” the elimination diet process by targeting foods that have triggered specific IgG antibody food reactions in the blood. One example of this strategy is the food intolerance programme offered by YorkTest Laboratories, the only programme of its kind recommended by the medical charity Allergy UK. The programme includes a finger-prick blood test for food-specific IgG antibodies, and support from a qualified Nutritional Therapist to help manage the dietary change required, all from the comfort of home. There is more research needed in this area, however, removal of foods from the diet that the body has reacted to in this way can reduce symptoms of food intolerance, usually where all else has failed! Where we have the option, we would rather be changing our diet than popping more pills. Wouldn’t we?